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成年和青少年囊性纤维化患者疼痛体验的描述

Descriptions of the Pain Experience in Adults and Adolescents with Cystic Fibrosis.

作者信息

Allgood Sarah J, Kozachik Sharon, Alexander Kamila A, Thaxton Abigail, Vera Marc, Lechtzin Noah

机构信息

Division of Pulmonary, Critical Care, and Sleep, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland; Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, Baltimore, Maryland.

Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, Baltimore, Maryland.

出版信息

Pain Manag Nurs. 2018 Aug;19(4):340-347. doi: 10.1016/j.pmn.2017.11.011. Epub 2018 Mar 1.

Abstract

BACKGROUND

People living with cystic fibrosis experience pain that is associated with decreased quality of life, poorer health outcomes, and increased mortality. Though pain is highly prevalent as a symptom, it is currently unknown how persons with CF describe their pain experiences or the ways those experiences impact their lives.

AIMS

To explore and describe ways adolescents and adults with CF experience pain. Design/Setting/Subjects/Methods: An exploratory descriptive design was implemented to perform interviews with 10 individuals with CF and self-reported moderate to severe pain. The interviews explored their pain experiences within five domains: Pain Characteristics, Activities, Relationships, Work/School Life, and Health Care Team. Transcribed interviews underwent a content analysis with team-based constant comparisons.

RESULTS

Individuals with CF identify the disease as being painful; express how pain negatively affects all aspects of their lives, including loss of functionality and productivity; and are able to disclose their pain to those with whom they have relationships. Adolescents feel an emotional toll from the loss of socialization as a result of pain and feel their health care team adequately supports their pain. Adults express a unique emotional pain component to CF and feel stigmatized and unsupported by their health care team when asking for pain management solutions.

CONCLUSION

There are differences in how pain is perceived by adolescents and adults with CF that have otherwise not been reported in the current literature. Further explorations of pain across the lifespan and health care provider attitudes toward pain management are needed to guide the development of effective pain management interventions for those with CF.

摘要

背景

囊性纤维化患者经历的疼痛与生活质量下降、健康状况较差及死亡率增加相关。尽管疼痛作为一种症状非常普遍,但目前尚不清楚囊性纤维化患者如何描述他们的疼痛经历,以及这些经历如何影响他们的生活。

目的

探讨并描述囊性纤维化青少年和成年人经历疼痛的方式。设计/地点/受试者/方法:采用探索性描述性设计,对10名患有囊性纤维化且自我报告有中度至重度疼痛的个体进行访谈。访谈在五个领域探讨了他们的疼痛经历:疼痛特征、活动、人际关系、工作/学校生活和医疗团队。对转录的访谈进行基于团队的持续比较的内容分析。

结果

囊性纤维化患者认为该疾病会引起疼痛;表达了疼痛如何对他们生活的各个方面产生负面影响,包括功能丧失和生产力下降;并且能够向他们有关系的人透露自己的疼痛。青少年因疼痛导致社交活动减少而感到情绪上的负担,并认为他们的医疗团队能充分支持他们应对疼痛。成年人则表达了囊性纤维化独特的情感疼痛成分,并且在寻求疼痛管理解决方案时,感到受到医疗团队的歧视且未得到支持。

结论

囊性纤维化青少年和成年人对疼痛的认知存在差异,而目前的文献中尚未有其他相关报道。需要进一步探索不同年龄段的疼痛情况以及医疗服务提供者对疼痛管理的态度,以指导为囊性纤维化患者开发有效的疼痛管理干预措施。

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